Provider Demographics
NPI:1639354533
Name:RICE, NEDRA L (MD)
Entity Type:Individual
Prefix:DR
First Name:NEDRA
Middle Name:L
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 W PARKER RD STE 330
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-0005
Mailing Address - Country:US
Mailing Address - Phone:469-367-0225
Mailing Address - Fax:469-367-0430
Practice Address - Street 1:6020 W PARKER RD STE 330
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-0005
Practice Address - Country:US
Practice Address - Phone:469-367-0225
Practice Address - Fax:469-367-0430
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5971207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX278831YUDOtherMEDICARE PTAN
TX327544801Medicaid